Working with Chemo Brain

You’re back at work after cancer treatment – or maybe
nearly done with treatment and working at least part
time. You’re understandably eager to get back to
“normal.” But if you’ve had chemotherapy, you may notice
your concentration, memory, or other work skills aren’t up
to par. This mental fog isn’t your imagination. It’s called
chemo brain. Experts actually prefer the terms cognitive
dysfunction associated with chemotherapy or post-chemo
brain to more accurately describe it.

What is Chemo Brain?
By whatever name, if you have
it, you know it: memory lapses, difficulty remembering details
or concentrating, inability to multitask like the master
you once were, problems remembering names or spelling
common words, inability to think as fast as you once did,
or difficulty remembering the steps of tasks you once performed
easily.

While experts say they have a lot to learn about chemo
brain, they do agree that it’s a real condition, not your imagination.
Research suggests it may linger after treatment. The
treatment itself may affect nerve and brain function, and
those effects may be complicated by the stress of coping with
the diagnosis and the fatigue from dealing with the stress and
an overloaded schedule. Some people may be more genetically
vulnerable to chemo brain than others.

Although research about chemo brain is still evolving,
there are many steps you can take at work to improve the
“fog” and perform better.

What You Can Do
Be aware of your stress level and
work to reduce the stress. Excess stress by itself can impair
your performance and thinking skills. Look to the source of
the stress – a coworker playing a radio too loudly, constant
chatter – and correct it. Learn quick-rescue techniques to
combat stress during the day. One technique is deep abdominal
breathing. Focus on breathing in deeply and exhaling
deeply until you feel more in control.

Minimize exposure to any toxins – whether it’s open
windows that let in polluted air or workplace materials
that are toxic. The aim is to keep your brain as healthy
as possible.

When you’re feeling overwhelmed, write down a list
of priorities (a good idea even if you’re not feeling overwhelmed).
Once you prioritize, tell yourself you will focus
only on the first task that needs to be done. Don’t think about
anything else. Otherwise, your concentration will suffer. As
distractions decrease, concentration increases.

While multitasking is viewed as very efficient – and you
may have been good at it before the cancer diagnosis – stop
for a while, at least until you regain a better memory and
other cognitive skills. Instead, focus on one task at a time.

Rely more than ever on memory assists and take advantage
of all the features. Perhaps you have always used a
computer-based calendar, for instance. Now, use the alerts
built into them to remind you of an upcoming meeting, a project
due date, or other details. Learn the features of your
smartphone that can help you stay on track.

Set up your work environment to boost concentration.
That means clearing everything off your desk or your immediate
work area except what you are currently working
on. Turn off your email. If you have difficulty ignoring the
world, create an “auto reply” message that tells people you
will respond at a specific time each day. Then, when you
do turn your attention to email, stay totally focused on that
task so you get it done quickly. You can do the same with
your voicemail greeting, choosing to return calls at a specific
time.

Rehearse to remember. If you read something aloud,
such as names or facts, some research suggests you are
less likely to forget it. The reasoning? Visual and aural
input together help you remember. You can use this technique
to talk yourself through challenging tasks at the
computer. Maybe there is a word processing technique
you used to know by heart but now don’t. Print out the
“help” instructions, then read them aloud and talk yourself
through it until it is second nature again.

Get in a rut. Put your keys, files, coat, and other items in
the same place day after day. It will reduce the “Where is it?”
stress when you are under fire and running late. At home,
designate a “launching pad” where you put everything you
need to take to work the next day – keys, files, day planners,
a jacket. It will reduce that early morning stress and allow
you to concentrate and focus.

How Coworkers Can Help
Ask for help from coworkers
you know and trust. Tell them you need input to see if your
work projects are up to standards. For instance, when you
write a report, show one of your helpers the rough draft and
ask for comments. Ask if you’ve missed any important points
or if you need to improve the grammar.

Interact with coworkers. Being in a socially stimulating
environment for some of the workday helps brain function.
This real-world connection is part of the recovery process.
Somehow, the combination of thinking and talking is good
for repairing the brain.

Ask a coworker you trust to help retrain you on the tasks
you’ve forgotten. If you generally distribute the mail in the
morning, or organize office parties, ask someone to walk you
through the steps if you are having difficulty. If a coworker
offers to do the task for you, gently decline and stress that
you are trying to relearn.

Ask a coworker to prompt you when he or she notices
you need help remembering names, facts, schedules, or
other details.

How to Manage Your Lifestyle to Improve Focus
Just
as your overall lifestyle habits affect your ability to perform
when you haven’t had chemo, they can improve or worsen
your chemo brain symptoms. Take stock of how you’re doing
on these basic lifestyle habits to keep chemo brain problems
to a minimum:

Get six to eight hours of sleep. Even if you feel you don’t
have time between doctor’s appointments and work, make
the time.

Fit in activity nearly every day. It doesn’t have to be an
hour workout at the gym, just focus on taking the stairs instead
of the elevator or going for a 20 to 30 minute walk.
Exercise is often the first thing people give up when stressed
for time, and it should be the last. Getting regular exercise
also helps you sleep better. It will improve your energy level,
sense of well-being, and thinking skills.

Improve your diet or maintain a healthy one.

♦ ♦ ♦ ♦ ♦

To learn more about returning to work after a cancer diagnosis, and for
free informational materials on dealing with cancer in the workplace,
visit CancerAndCareers.org.